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Are Gluten-Free Skin Care Products Necessary for Those with Celiac Disease?

But wheat is so yummy! :(
It seems that every few months or so, I see a new type of advertising that includes the phrase “something-free” on the label. Whether it’s silicone-free, paraben-free, sulfate-free, etc., these quasi-war cries are often mounted on to a product’s description to affirm a company’s support for the natural; for the pure; for the best. However, any person versed in cosmetic science knows that the overwhelming majority of these substances are not harmful or dangerous at the concentrations used in personal products. These companies are merely manipulating the consumers’ perception of their niche and “exclusive” brand. But I won’t get into that right now (or I’ll probably scream). In this post, we are going to discuss a seemingly more relevant and plausible “war cry,” and that is gluten-free skin care products.

Celiac Disease: What is It?    

The tissue transglutaminase enzyme is an important part of celiac disease.
The only known group of people that this particular subfield of skin care products affects is comprised of those with celiac disease (CD). This is because celiac disease is a disorder of the small intestine, where upon exposure to gliadin (a gluten protein found in foods such as wheat, barley, and rye), elicits an inflammatory immune response that involves the ubiquitous tissue transglutaminase enzyme. This can lead to chronic diarrhea, abdominal pain, and even multiple ulcer formulations. That’s not pretty. And we definitely don’t want to worsen the condition. Fortunately, since most gliadin proteins have molecular weights of between 16,000 to 50,000 Daltons, they are far too large to penetrate into the skin and be absorbed systemically. Therefore, it can be concluded that gluten-containing skin care products do NOT affect the celiac condition itself, as supported by the Mayo Clinic. It was further suggested that a rare skin manifestation of celiac disease, dermatitis herpetiformis, is also not affected by gluten-containing skin care products.

Celiac Disease: Contact Dermatitis

Remember, a lot of things can cause contact dermatitis. Always use caution when testing new products, no matter who you are.
However, it is important to explore the idea that those with celiac disease may have an increased susceptibility to experiencing contact dermatitis while using gluten-containing skin care products. This is because theoretically, when gliadins (there are three main types) come into contact with the skin of a celiac patient, the tissue transglutaminase enzyme in skin cells can deamidate them into compounds such as glutamic acid. These compounds will then be recognized by antigen-presenting cells (APCs), which will travel to a lymphatic node and label them as targets to be attacked by gluten-specific memory T-cells, which are part of the immune system. How much of this translates to real-life scenarios is relatively unknown. Only one study that I know of demonstrates this concept, where 14 female celiac patients experienced contact dermatitis after using gluten-containing skin care products. Upon discontinuing use, their contact dermatitis subsided. However, I have to note that this study only mildly supports the idea that those with celiac disease may have an increased tendency to experience contact dermatitis with gluten-containing skin care products. This is due in-part because of the small population size of the study; that the same products weren’t tested on non-celiac individuals; as well as the fact that the study was not vehicle-controlled (meaning that another class of ingredients like fragrances could have caused the reaction); nor were the patients or doctors blinded (meaning that the results could be due to the placebo effect; ever heard of self-fulfilling prophecies?).

Celiac Disease: What Should I Do?  

Always test out new products on a small area of the skin!
If you have celiac disease, don’t panic! Know that gluten-containing skin care products will not affect the actual celiac condition. However, it may be prudent to test gluten-containing products on the inside of the wrist or behind the ear for several days, before applying them all over the skin. But don’t stress out over this rather small risk. Also, I wouldn't recommending buying only products that are listed as "gluten-free." From a few cursory searches, the available formulations tend to be exceedingly mundane and not worthy of your $$$. Besides, there are gazillions of excellent skin care products on the market that don’t contain gluten, without necessarily being labeled as “gluten-free.” And I have to stress that when I mean gluten, I mean that it actually contains a gliadin protein. Just because something is derived from wheat or rye, doesn’t mean that it will trigger a reaction. Like gliadin for example, ferulic acid can be derived from wheat. But its structure and functions are so far removed from gliadin that to equate them would be a mistake. One more thing: it may also be prudent to use a separate skin care product for the eye area (it doesn't have to be labeled as an "eye" cream) that's been confirmed to be gluten-free, just to minimize exposure into the eyes. It's most likely that any product that gets into the eye area (which shouldn't be any!) won't be at a concentration that's sufficiently high enough to travel all the way to your small intestine and negatively affect that area. Also, make sure (and this should be common sense for those with celiac disease), to not use any lip products that contain gluten (gliadins). I hope this gave some of you out there a reason to sigh in relief, or at least knowledge so that you may make a more informed decision. Thanks for reading! ***Fun Fact: I got the idea to write about this issue from a post that had nothing to do with this topic. Haha!
By: John Su
Date: January 3 2013 at 2:10 PM
Q&A, allegy, bran, contact dermatitis, itching, oat, rice, rye, seed, transglutaminase, wheat

Comments (10)

  1. Tiffany Martin
    January 3 2013 at 2:55 PM

    I did not know that the risk was so low. I think it was a good question to answer! I mean, thinking about it this way can help celiac sufferers, but also people who want to understand celiac better. I liked reading this, John!

  2. John Su
    January 3 2013 at 3:08 PM

    @Tiffany Martin Thanks for reading! Glad you enjoyed it.

  3. Ginny
    January 3 2013 at 7:42 PM

    Would it be worth mentioning that lip care products with gluten could still trigger a reaction?

  4. John Su
    January 3 2013 at 10:06 PM

    @Ginny Well, I assumed that people with celiac disease (who have to go on an a permanent gluten-free diet) would know not to put anything on their lips that they might accidentally ingest. But yes, those with celiac disease should definitely avoid lip products that gliaidin-type proteins. :)

  5. Meire
    January 4 2013 at 5:40 AM

    Hello, Jonh It has been known for some time that gluten can't be absorbed by the skin, however many skin care products that are used on mouth and eyes contain gluten that could be absorbed by these mucosae and there's still the risk of hand to mouth cross contamination by handling such products. Considering the severity of celiac disease manifestations (like diabetes and other autoimmune diseases triggered by repeated exposition), I believe it's interesting to add further information like these to your blog post.. Congrats on your blog, it's very helpful :) Meire G.

  6. John Su
    January 4 2013 at 4:33 PM

    @Meire Thanks for the tip! But as I said to Ginny above, those with celiac disease should know not to get skin care products around the areas that allow for systemic exposure. And I'm sure they also know to always wash their hands after they use products. I mean, even I (who doesn't have anything to worry about) wash my hands after every application of skin care. But I'll add a notation into the post just to make sure people don't make this mistake. ;)

  7. Meire
    January 5 2013 at 5:34 AM

    John, Thanks! Meire

  8. John Su
    January 6 2013 at 9:40 PM

    @Meire Welcome, welcome!

  9. Julia Indigo
    January 10 2013 at 2:17 PM

    I was surprised to see you list silicone-free and sulfate-free as though there were no reasons to avoid those two. While it has nothing to do with my overall health, I find that sulfates in shampoos are too harsh on my curly hair, and many commonly used silicones require sodium laurel sulfate, et al, to be removed - otherwise they build up on the hair. Curly hair is generally not as 'strong' as straight hair, and flourishes with gentler treatment.

  10. John Su
    January 11 2013 at 12:33 PM

    @Julia Indigo Well, as I said in the article, when I mentioned all the other X-free categories, I meant that because a lot of people think that these ingredients are dangerous (remember that sulfate-causing cancer "controversy" a few years ago?), they incorrectly limit themselves to products that don't contain these ingredients. I didn't say that these labels were completely useless in helping consumers select products, though. But yeah, I'm glad to hear you've found what works for you!

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